Provider Demographics
NPI:1407673007
Name:MCCAULEY, CHRISTIE MARIE
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:MARIE
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5222 E 86TH ST APT 101
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-3026
Mailing Address - Country:US
Mailing Address - Phone:812-340-5082
Mailing Address - Fax:
Practice Address - Street 1:6748 E US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-8312
Practice Address - Country:US
Practice Address - Phone:317-825-8326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist